G-tube dressing change

[MrsWeb]

Hi,

I have a question regarding G-tube dressing changes. I have not been working much for the last few years, but do you still use the split-gauze dressing? Another nurse says they create an environment for infection. I was wondering if this is a new protocol. Anyone know? Thanks so much!

Stephanie

[VivaLasViejas, ASN, RN]

Hmmmmmmm..........I still use the 4X4 split drain sponges for G/T dressings, and indeed have rarely seen anything else used. Some people leave G/Ts entirely open to air, which is fine if the pt. doesn't have any 'gunk' oozing from the insertion site, but otherwise the drain sponges are fine, I think, as long as they're checked every so often and changed when they become dirty or damp. :)

[Nurse Hatchett]

I think it depends on the surgeon. One of our surgeons will have a fit if he finds out there is a 4x4 there, because he says it is infection/bacteria heaven. The rest of them have us use them. hope this helps???

[MrsWeb]

Thank you so much for your responses!

[barefootlady, ADN, RN]

I have noted on long term G tube placement that it is the lack of care to the insert site that causes problems rather than a specific type of dressing. The patient or caregiver should be taught to gently clean site with warm water and soap, pat dry gently, and examine site for s/s of breakdown. If site is clear apply dressing of either split drain 4 x 4's or regurlar 4 x 4's folded over. It will depend on physicians order. If insert site is red, oozing purulent drainage or has edema, physician needs to be called for orders. Here we usually apply an antibiotic ointment to site after cleaning and then dressing. G tube care should be done daily or every other day at least. Care of the tube does include flushing with water, at least 60 cc if there is no residual feeding found or less than 30 cc.

G tube do need to be changed but that takes a physicians order . Hope this is answer you wanted.

[grdmdb]

why are g tube dressing being put over the t adaptor? if we are looking to protect the skin from drainage this doesn't make any sense?

gina

[caliotter3]

Never saw the dressing placed over the T adaptor. Like you said, doesn't make sense. We have always followed the protocols listed in previous posts. Whatever the MD orders, is what we do. It is the nurse's responsibility to monitor the site and recommend to the MD when a change in orders might be appropriate. I've seen several doctor's orders where three methods of cleansing are listed to accommodate what the family has on hand and what the site looks like at the time. They also will order the creams for PRN use, leaving it to the discretion of the caregiver doing the g tube care.

[aramance]

In looking at some of the teaching of PEG care, placing the split dressing over the bar is done because placing it under that external bar can cause erosion of gastric tissue or abscess of the abdominal wall due to pressure on the internal bar within the stomach. Smith, S., et al. (2008) Clinical Nursing Skills: Basic to Advanced (8th edition). Upper Saddle River: Pearson Prentice Hall.

[KateRN1]

Way to revive a two-year-old dead thread.

[jg112679]

Hello Everyone,

I'm was doing a G-tube dressing change on my hospice patient & I found the dressing to have purulent drainage & blood on it. I called to advice the RN and she said to just place some neosporin on the gauze & place the gauze around the site. Is this correct? Please help...I'm an LVN but still have a lot to learn....

[Willow Moonsidhe]

That will not hurt at all. I see the sponge as a way to keep the tube from rubbing and causing skin breakdown. It seems to help to me.

Blessings

~Willow